Staphylococcus aureus (S. aureus) is a leading cause of Periprosthetic joint infection (PJI), a severe complication after joint arthroplasty. Immunosuppression is a major factor contributing to the infection chronicity of S. aureus PJI, posing significant treatment challenges. This study investigates the relationship between the immunosuppressive biofilm milieu and S. aureus PJI outcomes in both discovery and validation cohorts. This scRNA-seq analysis of synovium from PJI patients reveals an expansion and heightened activity of monocyte-related myeloid-derived suppressor cells (M-MDSCs) and regulatory T cells (Treg). Importantly, CXCL16 is significantly upregulated in M-MDSCs, with its corresponding CXCR6 receptor also elevated on Treg. M-MDSCs recruit Treg and enhance its activity via CXCL16-CXCR6 interactions, while Treg secretes TGF-β, inducing M-MDSCs proliferation and immunosuppressive activity. Interfering with this cross-talk in vivo using Treg-specific CXCR6 knockout PJI mouse model reduces M-MDSCs/Treg-mediated immunosuppression and alleviates bacterial burden. Immunohistochemistry and recurrence analysis show that PJI patients with CXCR6 synovium have poor prognosis. This findings highlight the critical role of CXCR6 in Treg in orchestrating an immunosuppressive microenvironment and biofilm persistence during PJI, offering potential targets for therapeutic intervention.
Staphylococcus aureus (S. aureus) is a leading cause of Periprosthetic joint infection (PJI), a severe complication after joint arthroplasty. Immunosuppression is a major factor contributing to the infection chronicity of S.
Purpose: This study investigated the epidemiology, risk factors, and outcomes of sepsis, a life-threatening complication, in the context of periprosthetic joint infections (PJI) of the hip and knee.
Methods: Sepsis was determined using the Sepsis-1 criteria. The cohort with PJI and sepsis was compared to patients who had PJI without sepsis.
Introduction: A sinus tract, an abnormal channel between the skin and joint, is a major criterion that proves the presence of an underlying periprosthetic joint infection. Its presence not only increases failure rates but also leads to poor outcomes. Despite its clinical relevance, little is known about risk factors and underlying microorganism profiles.
Background: Patients affected by chronic kidney disease (CKD) are at increased risk of periprosthetic joint infection (PJI) after total hip arthroplasty (THA). This patient population has a higher risk of recurrent infections and hospitalization. The aim of this study is to compare the profile of microorganisms in patients with CKD and PJI of the hip versus controls and to individuate potentially unusual and drug-resistant microorganisms among the causative bacteria.
Introduction Staphylococcus aureus stands as the predominant etiological agent in postoperative acute prosthetic joint infections (PJI), contributing to 35-50% of reported cases. This study aimed to evaluate the efficacy of dual prophylaxis incorporating cefuroxime and teicoplanin, in combination with nasal decolonization utilizing 70% alcohol, and oral and body lavage with chlorhexidine. Material and methods We conducted a retrospective review of electronic health records regarding primary and revision arthroplasties conducted at our institution from 2020 to 2021.
